The purposes of the proposed study are: a) to determine whether Flow Phonation can decrease Laryngeal Resistance (Rlaw)1 in patients with Muscle Tension Dysphonia (MTD); and b) establish the relationship between changes in measures of Rlaw and phonatory airflow to endoscopic, perceptual, acoustic, and handicap assessment ratings. MTD can have a debilitating effect on individuals who rely on their voices the most-teachers, preachers, salespeople, singers-costing them time, money, and even their jobs.2 It can lead to vocal fatigue, pain, and complete loss of voice. While treatments have emerged with some promising effects, no treatments have proven to have long-term benefits to all patients. Our preliminary data3 demonstrate Flow Phonation4 training resulted in significant decreases in Laryngeal Resistance to phonatory airflow with associated improvements in voice quality and voice handicap ratings. Sample size for our pilot study was small; no control group was utilized; and outcome measures were limited. In the proposed investigation, a larger sample will be obtained, a control group of participants receiving only Vocal Hygiene Training will be used for comparison during the first 3 weeks, and a wider range of outcome measures will be included over a longer period of time (1 year). This proposal is novel in that it provides the first perceptual, acoustic, endoscopic, voice handicap, and airflow data on Flow Phonation. The proposal is significant in that it will provide randomized, controlled clinical trial data for treatment which could help millions of Americans who suffer MTD annually, impacting their emotional and financial well-being.